Page 211 - Problem-Based Feline Medicine

12 – THE INCONTINENT CAT 203

Affected cats may voluntarily pass a small amount of
EXSTROPHY
urine with difficulty.
Classical signs Typically there is a large flaccid urinary bladder (detru-
sor atony), which is easily manually expressed.
● Urine dribbles from abdominal defect.
Other clinical signs usually predominate, such as an
acute onset over 24–48 h of depression and anorexia,
Clinical signs gastrointestinal signs (dysphagia, regurgitation, vomit-
ing, tenesmus, diarrhea, constipation), mydriasis, pro-
Very rare disorder in cats characterized by ventral mid-
lapsed third eyelids, dry mucous membranes and
line defects in the ventral abdominal wall, urinary blad-
bradycardia.
der, intestines and external genitalia.
Easily differentiated from other causes of incontinence
as urine dribbles from the abdominal defect.
Diagnosis
Diagnosis Diagnosis is based on clinical examination findings of
a flaccid bladder associated with acute onset of depres-
Diagnosis is based on clinical signs. Exstrophy should sion and gastrointestinal and ocular signs.
be differentiated from patent urachus.
Radiographic signs are of megesophagus and a dis-
tended urinary bladder.
FELINE DYSAUTONOMIA
Ophthalmological examination reveals reduced tear
Classical signs production, dilated poorly responsive pupils in a visual
cat, and prolapsed third eyelids.
● Dribbling urine.
● Distended bladder. Urodynamic procedures include the following:
● Gastrointestinal and ocular signs. ● Cystometry and urethral pressure profilometry may
be used to objectively evaluate detrussor and ure-
thral function.
Pathogenesis ● Cystometrograms can be used to show large filling
volumes, and lack of a sustained contractile peak
Feline dysautonomia is an autonomic polyganglionopa- indicates detrussor atony.
thy (Key–Gaskell syndrome). ● Urethral pressure profilometry can be used to iden-

Autonomic ganglia (sympathetic and parasympathetic) tify urethral incompetence.
are affected resulting in detrusor atony and urethral
sphincter incompetence.
Overflow incontinence occurs as a result. Treatment
Bethanecol is effective in inducing urination in some
cases, although it should not be used in cats with slow
Clinical signs
resting heart rates, as profound bradycardia and cardiac
Mainly seen in young cats. arrhythmia may occur.